Addressing Disparities in
Uterine Fibroid Embolization
October 15, 2025
Case
Anatomy
Literature
42-year-old woman
Hypertension, dyslipidemia, diabetes
Heavy menstrual bleeding, pelvic pressure, fatigue
What’s your differential?
What’s your differential?
Enlarged uterus (~14 weeks size)
Diagnosis?
What kind?
Type 0: pedunculated intracavitary
Type 1: <50% intramural
Type 2: ≥50% intramural
Type 3: 100% intramural; contacts endometrium
Type 4: intramural
Type 5: subserosal ≥50% intramural
Type 6: subserosal <50% intramural
Type 7: subserosal pedunculated
Type 8: other, e.g. cervical, parasitic
What next?
I Love Going Places In My Very Own Underwear!
I: iliolumbar artery
L: lateral sacral artery
G: gluteal (superior and inferior) arteries
P: (internal) pudendal artery
I: inferior vesical (vaginal in females) artery.
M: middle rectal artery
V: vaginal artery (females only)
O: obturator artery
U: umbilical artery and uterine artery (females only)
Reproductive plans and timing
Symptom severity and impact on quality of life
Treatment risks and recovery expectations
Long-term outcomes and recurrence risks
Personal values and preferences
ACOG Practice Bulletin #228 (2021)
ACR Appropriateness Criteria®
SIR Guidelines for UAE
ESHRE Guidelines on Fibroid Management